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PHARMACOLOGY > LEC - 7.2 - Beta & Calcium Blockers > Flashcards

LEC - 7.2 - Beta & Calcium Blockers Flashcards

1
Q

Location of Beta Receptors:

A

Heart (stimulation)

Bronchial, uterine, and vascular smooth muscle (relaxation)

Adipose tissue (lipolysis)

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2
Q

2 types of Beta Blockers:

A

Nonselective

Cardioselective

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3
Q

These drugs have similar antihypertensive effects irrespective of additional properties
Inhibit the secretion of renin and the formation of angiotensin I

A

Beta Adrenergic Blockers

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4
Q

Therapeutic applications of Beta Blockers

A

decreases cardiac workload and can ease the symptoms of angina pectoris. By slowing conduction through the mycardium, they treat dysrhythmias. They are also included in the treatment of heart failure, MI and migraine.

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5
Q

These beta blockers block both beta1 and beta2 receptors and so affect the heart, lungs, vascular smooth muscles, kidneys, GI, etc

A

Nonselective Beta Blockers

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6
Q

These bete blockers work by blocking beta-1 receptors, which prevents epinephrine from binding to these receptors. As a result, these medications block the effects of epinephrine, also known as adrenaline, in order to decrease heart rate and the contractility of the heart

A

Cardioselective Beta Blockers

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7
Q

Examples of Nonselective Beta Blockers:

A

ropranolol
nadolol
timolol
pindolol
labetolol
carvedilol

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8
Q

Examples of Cardioselective Beta Blockers:

A

metoprolol
atenolol
esmolol
betaxolol

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9
Q

Non Cardiovascular Uses for Beta Blockers:

A

Migraine
In anxiety provoking situations
Glaucoma
Hyperthyroidism
Pheocromocytoma
Alcohol withdrawal
Oesophageal varices

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10
Q

Advantages of Beta Blockers

A

No postural hypotension
No salt and water retention
Low incidence of side effects
Low cost
Once a day regimen
Preferred in young non-obese patients, prevention of sudden cardiac death in post infarction patients and progression of CHF

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11
Q

Side effects of Beta Blockers:

A

Fatigue, lethargy or decreased work capacity
Loss of libido or impotence
Cognitive defects like forgetfulness

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12
Q

Adverse effects of Beta Blockers:

A

Bronchoconstriction
Bradycardia
Cold extremeties
CNS side effects
Heart Failure
Hypoglycemia
Rebound hypertension

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13
Q

Advantages of cardio-selective over non-selective:

A

Safe for use in:
Asthma
Diabetes mellitus
Peripheral vascular disease
Preferred in young non-obese hypertensive
Angina pectoris and post angina patients
Post MI patients – useful in preventing mortality
In old persons, carvedilol, which has a vasodilatory action can be given

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14
Q

Lowers BP directly by blocking the sympathetic receptor in arterioles causing the vessels to dilate

A

Alpha Adrenergic Blockers

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15
Q

These drugs are not the first-line drugs for HTN because long-term clinical trials have shown them to be less effective at reducing the incidence of serious cardiovascular events than diuretics.

A

Alpha Adrenergic Blockers

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16
Q

Non selective alpha blockers like ___ and ___ are not used in chronic essential hypertension but only in pheochromocytoma (vascular tumor of chromaffin tissue of the adrenal medulla).

A

phenoxybenzamine and phentolamine

17
Q

Non selective alpha blockers like phenoxybenzamine and phentolamine are not used in chronic essential hypertension but only in ___ (vascular tumor of chromaffin tissue of the adrenal medulla).

A

pheochromocytoma

18
Q

vascular tumor of chromaffin tissue of the adrenal medulla

A

pheochromocytoma

19
Q

Specific alpha-1 blockers like ___, ___, and ___ are used in chronic essential hypertension

A

prazosin, terazosin and doxazosine

20
Q

Specific alpha-1 blockers like prazosin, terazosin and doxazosine are used in ___

A

chronic essential hypertension

21
Q

___ is effective against benign prostatic hypertrophy (BPH)

A

Tamsulosin

22
Q

Tamsulosin is effective against ___

A

benign prostatic hypertrophy (BPH)

23
Q

Therapeutic Uses of Alpa-Blockers:

A

Reduction in mean BP
Does not produce tachycardia since presynaptic auto or alpha-2 receptors are not inhibited
Autoregulation of Na+ release remains intact

24
Q

Adverse effects of Alpa-Blockers:

A

Prazosin causes postural hypotension so start with 0.5 mg at bed time with increasing dose and up to 10 mg daily
Fluid retention in monotherapy
Headache, dry mouth, weakness, blurred vision, rash, drowsiness and failure of ejaculation in males

25
Q

___ causes postural hypotension so start with 0.5 mg at bed time with increasing dose and up to 10 mg daily

A

Prazosin

26
Q

Prazosin causes postural hypotension so start with ___ mg at bed time with increasing dose and up to ___ mg daily

A

0.5

10

27
Q

Current status of Alpa-Blockers:

A

Improvement of carbohydrate metabolism so beneficial for diabetics since it lowers LDL and increases HDL
Not used as first line agent
Used in addition with other conventional drugs which are failing such as diuretic or beta blocker

28
Q

Other example:

A

Minipress
Prazopress

29
Q

these drugs prevent the movement of calcium into the cardiac and smooth muscle cells when the cells are stimulated

Blocking of calcium interferes with the muscle cell’s ability to contract, leading to a loss of smooth muscle tone, vasodilation, and a decrease in peripheral resistance

A

Calcium Channel Blockers

30
Q

Calcium channel blockers are effective in the treatment of ___

A

angina

31
Q

Examples of Calcium Channel Blockers available in the Philippines:

A

Amlodipine (Norvasc)
Felodipine (Plendil ER)
Nifedipine ( Adalat, Calcibloc)
Diltiazem ( Dilzem)
Nicardipine (Cardepine)

32
Q

Potential Side Effects of Calcium Blockers:

A

Dizziness or lightheadedness
Low blood pressure
Heart rhythm problems
Dry mouth
Edema (swelling of ankles, feet, or lower legs)
Headache

33
Q

Potential Side Effects of Calcium Blockers:

A

Nausea
Fatigue
Skin rash
Constipation or diarrhea
Gastroesophageal reflux disease

34
Q

Advantages of Calcium Blockers:

A

Unlike with diuretics, there is no adverse metabolic effects but mild adverse effects like dizziness, fatigue, etc.
No sedation or CNS effect
Can be given to asthma, angina and PVD patients
No renal and male sexual function impairment
No adverse fetal effects and can be given in pregnancy
Minimal effect on quality of life

35
Q

CCBs are not 1st line of antihypertensive unless indicated but rather the use of ACE Inhibitors/diuretics/beta blockers. However it is been used because of excellent tolerability and high efficacy

A

NA

36
Q

Preferred in elderly because it prevents stroke

A

Calcium Channel Blockers

37
Q

CCBs are next to ACE inhibitors in inhibition of ___ and prevention of ___

A

albuminuria

diabetic nephropathy

38
Q

CCBs nteract with ___ causing an increase level of calcium channel blockers to toxic dose

A

grapefruit juice

PHARMACOLOGY (20 decks)

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